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Respite Services for Families of Children with Mental Health Needs: A Scarce Resource

Beth Hess - Wednesday, August 09, 2017

Respite is a service that is designed so that caregivers can get a break from the stress of providing care for a loved one with significant special needs, thereby promoting the capacity of people with disabilities or disorders to remain in the community. Respite is provided in different ways across age groups (e.g. senior care) and across disabilities. For families of children with mental health needs, respite can be difficult to access.

There are both in-home and out-of-home respite services. For in-home respite services, a provider from an approved program comes into the home, or takes the child out into the community, for a few hours to give the family a needed break. The number of hours and frequency of the visits varies depending on each situation. Out-of-home respite is an overnight service. It can be provided by a residential respite program or a treatment foster care home. Typically out-of-home respite is provided for one or two nights at a time, with varying frequency.

A child’s family can be eligible to receive respite services through different avenues. One is the 1915(i) Medicaid State Plan Amendment. If a child is enrolled in the 1915(i), their family is entitled to receive respite services.

There are other avenues as well. The Behavioral Health Administration (BHA) has been funding respite services for children and adolescents since the late 1990’s. State general funds also support respite services, and a few counties fund respite. All of these funding sources are limited, however, as are the number of respite providers. In order to receive respite services, a child must:

be Medicaid eligible (in a few jurisdictions, there are a limited number of slots for families who are not on Medicaid)

be in active mental health treatment

live in an area where there is a respite provider

In addition to the above, they must meet the eligibility criteria of a particular respite provider (this varies from provider to provider).

In order to access respite services, a child’s clinician must make the determination that respite services would be appropriate and either directly refer the family to a respite provider, or make a referral for services to the local Core Service Agency (CSA), which is required in certain jurisdictions. The respite provider or CSA will determine eligibility and seek authorization for payment of services. Even if a child is found eligible, there may be a waiting list to receive respite services. Waiting lists can be for an indefinite period of time.

BHA recognizes that there continues to be a shortage of funding and providers to meet the respite needs of caregivers of children with behavioral health needs. MCF is working with BHA and respite providers to address the problem and develop solutions to expand respite services in Maryland. If you’ve had experience with accessing respite services, either positive or negative, please contact MCF Director of Public Policy Ann Geddes at ageddes@mdcoalition.org so that this information can be shared with the appropriate staff at BHA.

Lifespan Respite Care - Emergency Care Services Available

September 2017 Update: Limited funds (a maximum grant of $225 per family) for emergency respite care have become available. An emergency is defined as an unplanned event that requires the unavoidable absence of the primary caregiver of a person with special healthcare needs. Respite services must be needed within 72 hours of the request and may be provided in-home or out-of-home. Restrictions apply. Learn more.

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